MedPath

Efficacy and Safety of IgPro10 in Adults With Systemic Sclerosis (SSc)

Phase 2
Withdrawn
Conditions
Diffuse Cutaneous Systemic Sclerosis
Interventions
Biological: IgPro10
Biological: Placebo
Registration Number
NCT04138485
Lead Sponsor
CSL Behring
Brief Summary

This randomized, multicenter, double-blind (DB), placebo controlled, phase 2 study will evaluate the efficacy and safety of IgPro10. The DB Treatment Period will be followed by a 24-week Open-label (OL) Treatment Period.

Eligible subjects will be randomized at Baseline in a 2:1 ratio of treatment IgPro10 or placebo in the DB Treatment Period. All subjects who enter OL Treatment Period will receive IgPro10.

Detailed Description

Not available

Recruitment & Eligibility

Status
WITHDRAWN
Sex
All
Target Recruitment
Not specified
Inclusion Criteria
    1. Age ≥18 years (male or female) at time of providing written informed consent
  • Documented diagnosis of SSc according to ACR / EULAR criteria 2013
  • mRSS ≥ 15 and ≤ 45
  • Disease duration ≤ 5 years defined as the time from the first non-Raynaud's phenomenon manifestation
  • Subjects within first 18 months of disease duration from first non-Raynaud's phenomenon manifestation.
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Exclusion Criteria
  • Primary rheumatic autoimmune disease other than dcSSc, including but not limited to rheumatoid arthritis, systemic lupus erythematosus, mixed connective tissue disorder, polymyositis, and dermatomyositis, as determined by the investigator Note: Subjects with fibromyalgia, secondary Sjogren's syndrome, and scleroderma-associated myopathy or myositis at Screening are not excluded
  • Positive anti-centromere autoantibodies at Screening
  • Evidence of severe chronic kidney disease with estimated glomerular filtration rate < 45 mL/min/1.73 m2 (as calculated by the Chronic Kidney Disease Epidemiology Collaboration equation) or receiving dialysis. Additionally, subjects with current confirmed diagnosis of diabetes mellitus and requiring medication, with eGFR < 90 mL/min/1.73m2 will be excluded from the study.
  • History of documented thrombotic episode eg, PE, DVT, myocardial infarction, thromboembolic stroke at any time Note: past superficial thrombophlebitis more than two years from Screening is not exclusionary
  • Documented thrombophilic abnormalities including blood hyperviscosity, protein S or protein C deficiency, anti-thrombin-3 deficiency, plasminogen deficiency, antiphospholipid syndrome, Factor V Leiden mutation, dysfibrinogenemia, or prothrombin G20210A mutation
  • Greater than 3 specified current risk factors for TEEs (documented and currents conditions): atrial fibrillation, coronary disease, diabetes mellitus, dyslipidemia, hypertension, obesity (Body Mass Index ≥ 30 kg/m2), recent significant trauma, and immobility (wheelchair-bound or bedridden)
  • Ongoing active serious infection at Screening (including, but not limited to, pneumonia, bacteremia/septicemia, osteomyelitis/septic arthritis, bacterial meningitis, or visceral abscess)
  • Malignancy in the past 2 years, except for non-melanoma skin cancer, cervical carcinoma in situ, or other in situ cancer if it has been excised and treated within in the past year
  • Known hypoalbuminemia, protein-losing enteropathies, and any proteinuria (defined by total urine protein concentration > 0.2 g/L)
  • Known IgA deficiency or serum IgA level < 5% lower limit of normal
Read More

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
IgPro10IgPro1010% liquid formulation of human immunoglobulin for intravenous use
PlaceboPlacebo0.5% human albumin solution stabilized with 250 mmol/L L-proline
Primary Outcome Measures
NameTimeMethod
Response on American College of Rheumatology Combined Response Index in Diffuse Systemic Sclerosis (ACR CRISS) score in IgPro10 vs PlaceboOver 48 weeks
Secondary Outcome Measures
NameTimeMethod
Proportion of subjects meeting cardiopulmonary or renal failure criteria in ACR CRISS Step 1 eventsOver 48 weeks
Proportion of responders (ACR CRISS > 0.6)Over 72 weeks
Mean change from Baseline in Modified Rodnan Skin Score (mRSS)Baseline and over48 weeks
Mean change from Baseline in Health Assessment Questionnaire - Disability Index (HAQ-DI)Baseline and over 72 weeks
Mean change from Baseline in Forced Vital Capacity (FVC)% predictedBaseline and over 72 weeks
Mean change from Baseline in diffusing capacity of lung for carbon monoxide (DLCO)% predictedBaseline and over 72 weeks
Mean change from Baseline in Physician Global Assessment (MDGA)Baseline and over 72 weeks
Mean change from Baseline in Patient Global Assessment (PGA)Baseline and over 48 weeks

PGA evaluates the overall impact of SSc on the participant as assessed by the physician on a 11-point Numeric rating scale scale from 0 (excellent) to 10 (extremely poor)

Mean change from Baseline in UCLA Scleroderma Clinical Trial Consortium Gastrointestinal Tract 2.0 (UCLA SCTC GIT 2.0) total score and subscaleBaseline and over 48 weeks

This survey consists of 34 questions and items are scored on a scale of 0 (better health) to 3 (worse health). Scores are combined to form total score.

Mean change from Baseline in Scleroderma Skin Patient Reported Outcome (SSPRO) score in IgPro10 vs PlaceboBaseline and up to 48 weeks
Proportion of responders in mRSSUp to 48 weeks

Response is decrease of mRSS ≥ 5 points and change of ≥ 25% from Baseline in IgPro10 vs Placebo

Time to treatment failure (time from first infusion to time of first event) in IgPro10 vs PlaceboOver 48 weeks

Treatment failure - defined as occurrence of SSc associated complications in ACR CRISS step 1 events, digital ischemia (requiring hospitalization for IV prostacyclin, surgical intervention or amputation), serious gastrointestinal events (events requiring parenteral nutrition due to SSc -such as total parenteral nutrition or enteral nutrition), all-cause mortality

Proportion of subjects with events at Week 48 in IgPro10 vs PlaceboOver 48 weeks

Events defined as occurrence of SSc associated complications in ACR CRISS step 1 events, digital ischemia (requiring hospitalization for IV prostacyclin, surgical intervention or amputation), serious gastrointestinal events (events requiring parenteral nutrition due to SSc -such as total parenteral nutrition or enteral nutrition), all -cause mortality

Mean change from Baseline in Cochin Hand Function Scale in IgPro10 vs PlaceboBaseline and over 48 weeks
Mean change from Baseline in Scleroderma Health Assessment Questionnaire (SHAQ) score in IgPro10 vs PlaceboBaseline and over 48 weeks
Mean change from baseline in muscle strength as measured by Manual Muscle Testing 8 (MMT) in IgPro10 vs PlaceboBaseline and over 48 weeks
Number of subjects with adverse events (AEs) including any AEs, treatment-emergent AEs (TEAEs), serious AEs (SAEs), and AEs of special interest (AESIs)Over 72 weeks
Percentage of subjects with AEs, TEAEs, SAEs, AESIsOver 72 weeks
Concentration of serum trough IgG levels at Baseline and prior to first infusionBaseline and up to 72 weeks
Mean change from Baseline in Modified Rodnan skin score (mRSS)Baseline and over 72 weeks
Mean change from Baseline in Patient global assessment (PGA)Baseline and over 72 weeks

Trial Locations

Locations (77)

Louisiana State University Health Sciences Center

🇺🇸

Shreveport, Louisiana, United States

Rutgers Clinical Research Center

🇺🇸

New Brunswick, New Jersey, United States

Boston University Amyloidosis Center

🇺🇸

Boston, Massachusetts, United States

University of California

🇺🇸

Los Angeles, California, United States

University of Michigan Health System

🇺🇸

Ann Arbor, Michigan, United States

Lombardi Cancer Center-Georgetown University

🇺🇸

Washington, District of Columbia, United States

Pacific Arthritis Care Center

🇺🇸

Los Angeles, California, United States

Alliance for Multispecialty Research

🇺🇸

Wichita, Kansas, United States

John Hopkins Bayview Medical Center

🇺🇸

Baltimore, Maryland, United States

Hospital Italiano de Buenos Aires

🇦🇷

Buenos Aires, Argentina

Medical University of South Carolina

🇺🇸

Charleston, South Carolina, United States

Altoona Center For Research

🇺🇸

Duncansville, Pennsylvania, United States

The University Of Texas Medical School At Houston (Utms)

🇺🇸

Houston, Texas, United States

UZ Gent

🇧🇪

Gent, Belgium

Universitaire Ziekenhuizen Leuven - Campus Gasthuisberg

🇧🇪

Leuven, Belgium

John Hunter Hospital / Autoimmune Resource and Research Centre

🇦🇺

New Lambton Heights, New South Wales, Australia

CHU de Caen

🇫🇷

Caen, France

CHRU de Lille Hopital Huriez

🇫🇷

Lille Cedex, France

Kerckhoff Klinik GmbH, Abteilung für Rheumatologie und Klinische Immunologie Rheumatologie

🇩🇪

Bad Nauheim, Germany

CHU Hautepierre

🇫🇷

Strasbourg, France

Universitaetsmedizin Berlin - Campus Charite Mitte (CCM)

🇩🇪

Berlin, Germany

Centre Hospitalier Universitaire de Rouen-Hopital

🇫🇷

Rouen cedex, France

University Hospital Of Tuebingen

🇩🇪

Tuebingen, Germany

Modena University

🇮🇹

Modena, Italy

Uniwersytecki Szpital Kliniczny W Bialymstoku

🇵🇱

Bialystok, Poland

Hospital Universitari Materno Infantil Vall Dhebron

🇪🇸

Barcelona, Spain

Universita degli Study di Ancona

🇮🇹

Ancona, Italy

Universita Degli Studi Di Bari Aldo Moro

🇮🇹

Bari, Italy

Azienda Ospedaliera Gaetano Pini

🇮🇹

Milano, Italy

Universita degli Studi di Napoli Federico II

🇮🇹

Napoli, Italy

IRCCS Policlinico San Matteo

🇮🇹

Pavia, Italy

Dip.to Med. Sperimentale -Polic.Umberto I -Univ. La Sapienza

🇮🇹

Rome, Italy

Hospital de la Santa Creu i Sant Pau

🇪🇸

Barcelona, Spain

Mayo Clinic Arizona - Scottsdale

🇺🇸

Scottsdale, Arizona, United States

Stanford University Medical Center

🇺🇸

Palo Alto, California, United States

Heartland Research Associates, LLC

🇺🇸

Wichita, Kansas, United States

University of Colorado

🇺🇸

Aurora, Colorado, United States

Mount Sinai Hospital, The Rebecca Macdonald Centre For Arthritis

🇨🇦

Toronto, Canada

University of Pennsylvania - Perelman Center

🇺🇸

Philadelphia, Pennsylvania, United States

Northwell Health

🇺🇸

Great Neck, New York, United States

APRILLUS Asistencia e Investigacion Clinica

🇦🇷

Buenos Aires, Argentina

Sanatorio Parque S.A y Consultorios Externos Asociados

🇦🇷

Rosario, Argentina

Internal Medicine, Nantes University Hospital

🇫🇷

Nantes, France

CHU de Rennes-Hopital Sud

🇫🇷

Rennes, France

Assistance Publique - Hopitaux de Paris (AP-HP)

🇫🇷

Paris, France

Universitaetsklinikum Freiburg- Klinik fuer Rheumatologie und Klinische Immunologie

🇩🇪

Freiburg, Germany

Charite - Universitaetsmedizin Berlin - Campus Charite Mitte

🇩🇪

Berlin, Germany

Universitaetsmedizin der Johannes Gutenberg

🇩🇪

Mainz, Germany

Universita degli Studi Di Brescia

🇮🇹

Brescia, Italy

Universita degli Studi Firenze

🇮🇹

Firenze, Italy

UOC Immunoreumatologia

🇮🇹

L'Aquila, Italy

University Hospital of Cologne

🇩🇪

Köln, Germany

Universitaetsklinikum Ulm

🇩🇪

Ulm, Germany

Centro de Investigacion y Tratamiento Reumatologico S.C.

🇲🇽

Ciudad de México, Mexico

Centro Integral en Reumatologia, SA de CV

🇲🇽

Guadalajara, Mexico

Centro De Estudios De Investigation Basica Y Clinica S.C

🇲🇽

Jalisco, Mexico

Cliditer, S.A. DE C.V.

🇲🇽

Mexico City, Mexico

Instituto Nacional De Ciencias Medicas Y Nutricion

🇲🇽

Mexico, Mexico

Centro de Alta Especialidad en Reumatologia

🇲🇽

San Luis Potosi, Mexico

Klinika i Poliklinika Układowych Chorób Tkanki Łącznej Narodowy Instytut Geriatrii, Reumatologii i Rehabilitacji

🇵🇱

Warszawa, Poland

Complejo Hospitalario Universitario A Coruna

🇪🇸

A Coruna, Spain

University Clinical Centre, Medical University of Gdansk

🇵🇱

Gdańsk, Poland

Samodzielny Publiczny Szpital Kliniczny

🇵🇱

Katowice, Poland

Klinika Dermatologii Szpital im. Dzieciątka Jezus

🇵🇱

Warszawa, Poland

Hospital General Universitario Gregorio Maranon

🇪🇸

Madrid, Spain

Royal Free Hospital-Royal Free London NHS Foundation Trust

🇬🇧

London, United Kingdom

Countess of Chester Hospital

🇬🇧

Chester, United Kingdom

Hospital Univ 12 de Octubre

🇪🇸

Madrid, Spain

Hospital Infanta Luisa Quirónsalud

🇪🇸

Sevilla, Spain

Hospital Universitari Dr.Peset

🇪🇸

Valencia, Spain

Cantonal Hospital St. Gallen - Klinik fuer Rheumatologie

🇨🇭

Saint Gallen, Switzerland

Chapel Allerton Hospital

🇬🇧

Leeds, United Kingdom

PARC Clinical Research

🇦🇺

Adelaide, South Australia, Australia

Cleveland Clinic - Taussig Cancer Center

🇺🇸

Cleveland, Ohio, United States

Hospital For Special Surgery

🇺🇸

New York, New York, United States

Hospital St. Josef

🇩🇪

Wuppertal, Germany

Hospital Militar Central

🇦🇷

Ciudad Autonoma de Buenos Aires, Argentina

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